Abstract. We used the Centers for Disease Control and Prevention-Kenya Medical Research Institute Acute Respiratory Infection (ARI) Surveillance System data to estimate severe acute respiratory infection (SARI) hospitalization rates, viral etiology, and associated complaints of influenza-like illnesses (ILI) and SARI conditions among those aged 5 years and older in Hagadera, Dadaab refugee camp, Kenya, for 2010-2012. A total of 471 patients aged ≥ 5 years met the case definition for ILI or SARI. SARI hospitalization rates per 10,000 person-years were 14.7 (95% confidence interval [CI] = 9.1, 22.2) for those aged 5-14 years; 3.4 (95% CI = 1.6, 7.2) for those aged 15-24 year; and 3.8 (95% CI = 1.6, 7.2) for those aged ≥ 25 years. Persons between the ages of 5 and 14 years had 3.5 greater odds to have been hospitalized as a result of SARI than those aged ≥ 25 years (odds ratio [OR] = 3.5, P < 0.001). Among the 419 samples tested, 169 (40.3%) were positive for one or more virus. Of those samples having viruses, 36.9% had influenza A; 29.9% had adenovirus; 20.2% had influenza B; and 14.4% had parainfluenza 1, 2, or 3. Muscle/joint pain was associated with influenza A (P = 0.002), whereas headache was associated with influenza B (P = 0.019). ARIs were responsible for a substantial disease burden in Hagadera camp.

Dadaab Refugee camp in Garissa County, Kenya, hosts nearly 340,000 refugees in five subcamps (Dagahaley, Hagadera, Ifo, Ifo2, and Kambioos) (1). On November 18 and 19, 2015, during an ongoing national cholera outbreak (2), two camp residents were evaluated for acute watery diarrhea (three or more stools in ≤24 hours); Vibrio cholerae serogroup O1 serotype Ogawa was isolated from stool specimens collected from both patients. Within 1 week of the report of index cases, an additional 45 cases of acute watery diarrhea were reported. The United Nations High Commissioner for Refugees and their health-sector partners coordinated the cholera response, community outreach and water, sanitation, and hygiene (WASH) activities; Médecins Sans Frontiéres and the International Rescue Committee were involved in management of cholera treatment centers; CDC performed laboratory confirmation of cases and undertook GIS mapping and postoutbreak response assessment; and the Garissa County Government and the Kenya Ministry of Health conducted a case-control study. To prevent future cholera outbreaks, improvements to WASH and enhanced disease surveillance systems in Dadaab camp and the surrounding area are needed.

Background On 27 th March 2019, the Hagadera Refugee Camp reported an outbreak of acute watery diarrhea. An investigation was initiated to confirm the causative organism and define the epidemiology of the outbreak to support evidence-based control measures. Method A suspected case was a resident of Hagadera Refugee Camp or the surrounding community with a sudden onset of acute watery diarrhea and vomiting between March 27 and September 16, 2019. A probable case was defined as a suspected case with a positive rapid test for Vibrio cholerae; a confirmed case was a probable case with a positive stool culture for V. cholerae. We conducted a systematic case finding by visiting health facilities and villages. We reviewed patient records to identify suspected cholera casepatients. We conducted a descriptive epidemiologic study, examining the distribution of the cases. We computed the attack rates by age, sex, and residence. The case fatality rate was calculated as the ratio of the total number of suspected cholera death to the total number of cholera case-patients. We conducted targeted interventions including spraying, handwashing demonstration, distribution of soaps health education and promotion. Results We identified 667 suspected cholera cases between March and September 2019 of these, 38% (253/667) had a positive rapid diagnostic test for V. cholerae; 6% (43) were negative and 56%(371) rapid diagnostic test (RDT) were not conducted. Out of the 94 rectal swabs for culture, 71% (64/94) were confirmed to be V. cholera O1 serotype Inaba. The epidemic curve exhibited a continuous common-source outbreak with several peaks. The mean age of the case-patients was 15-years (range: 0.2-70-years). Both males and female had an attack rate of 9/10000 respectively. The highest attack rate was in ≥30-years (14 per 10,000). Conclusion This was a continuous common source cholera outbreak caused by V. cholerae 01 serotype Inaba. We recommended strengthening the surveillance system improving early detection and effective response.